Post-partum Depression

Many new mothers may feel "blue" after the birth of their baby. This may be caused by a change in hormones, not getting enough sleep, feeling too busy, or just worried about taking care of the baby.

Post-partum depression is a medical condition, not a sign of weakness. Be honest with yourself and those who care about you. Tell them about your struggle. You, your doctor, and your friends and family can team up to treat your symptoms.

• Plan activities and visit with friends and family, and ask them to call you regularly.
• Eat a nutritious diet. Eat small snacks throughout the day to keep up your energy.
• Get daily exercise, such as outdoor stroller walks. Exercise helps improve mood.
• Get as much sunlight as possible-keep your shades and curtains open, and get outside as much as you can.
• Ask for help with food preparation and other daily tasks. Family and friends are often happy to help a mother with newborn demands.
• Don't overdo it. Get as much rest and sleep as possible. Fatigue can increase depression.
• Do not use alcohol or caffeine.

Join a support group of new mothers. No one can better understand and support the challenges of caring for a new baby than other post-partum women.

Symptoms

Post-partum blues. A certain amount of insomnia, irritability, tears, overwhelmed feelings, and mood swings are normal during the first days after childbirth. These "baby blues" usually peak around the fourth post-partum day and subside in less than 2 weeks, when hormonal changes have settled down. If you have post-partum blues after childbirth, you're not alone-more than half of women have temporary mild symptoms of depression mixed with feelings of happiness after having a baby.1
Be sure to report any feelings of post-partum blues to your health professional at your first post-partum checkup, so he or she can follow up with you.

Post-partum depression (PPD). Symptoms of post-partum depression can follow post-partum blues. They can feel like more of the same, or worse than before. Post-partum depression can also happen months after childbirth or pregnancy loss. In some cases, symptoms peak after slowly building for 3 or 4 months. Possible PPD symptoms require evaluation by a health professional.

If you have post-partum depression, you have had five or more depressive symptoms (including one of the first two listed below) for most of the past 2 weeks, including:

• Depressed mood-tearfulness, hopelessness, and feeling empty inside, with or without severe anxiety.
• Loss of pleasure in either all or almost all of your daily activities.
• Appetite and weight change-usually a drop in appetite and weight, but sometimes the opposite.
• Sleep problems-usually trouble with sleeping, even when your baby is sleeping.
• Noticeable change in how you walk and talk-usually restlessness, but sometimes sluggishness.
• Extreme fatigue or loss of energy.
• Feelings of worthlessness or guilt, with no reasonable cause.
• Difficulty concentrating and making decisions.
• Thoughts about death or suicide. Some women with PPD have fleeting, frightening thoughts of harming their babies: these thoughts tend to be fearful thoughts, rather than urges to harm.

Early treatment of PPD is important for both you and your baby. It may be helpful to make a list of post-partum depression symptoms that you can take to your health professional. See a post-partum depression checklist (What is a PDF document?).

Postpartum psychosis. This severe condition is most likely to affect women with bipolar disorder or a history of postpartum psychosis. Symptoms, which usually develop during the first 3 post-partum weeks (as soon as 1 to 2 days after childbirth), include:

• Feeling removed from your baby, other people, and your surroundings (depersonalization).
• Disturbed sleep, even when your baby is sleeping.
• Extremely confused and disorganized thinking, increasing your risk of harming yourself, your baby, or another person.3
• Drastically changing moods and bizarre behavior.
• Extreme agitation or restlessness.
• Unusual hallucinations, often involving sight, smell, or touch.
• Delusional thinking that isn't based in reality.

Postpartum psychosis is considered an emergency requiring immediate medical treatment. If you have any psychotic symptoms, seek emergency help immediately. Until you tell your health professional and get treatment, you are at high risk of suddenly harming yourself or your baby.